text:
Page 1
Journal of Applied
Ecology 2001
38, 1362–1370
© 2001 British
Ecological Society
Blackwell Science Ltd
Estimating disease transmission in wildlife, with emphasis
on leptospirosis and bovine tuberculosis in possums, and
effects of fertility control
PETER CALEY*† and DAVE RAMSEY*‡
*Landcare Research and ‡Marsupial Cooperative Research Centre at Landcare Research, Private Bag 11052,
Palmerston North 5301, New Zealand; and †Applied Ecology Group, University of Canberra, ACT 2601, Australia
1. We present methods for estimating disease transmission coefficients in wildlife, using
Leptospira interrogans infection (a bacterial disease transmitted predominantly during
social contacts) in brushtail possums Trichosurus vulpecula as a model system.
2. Using data from a field experiment conducted on a naturally infected possum
population, we estimated disease transmission coefficients assuming either 'density-
dependent' or 'frequency-dependent' transmission.
3. A model-selection approach determined that density-dependent transmission was
the most appropriate form of the transmission of L. interrogans infection in brushtail
4. We used the chosen model of transmission to examine experimentally the effect of
tubally ligating female brushtail possums on the epidemiology of L. interrogans. The
estimated transmission coefficient was 28% higher (P = 0·16) in populations subject to
tubal ligation, raising the possibility that fertility control of this type may increase dis-
ease transmission rates.
5. Altering mating behaviour through fertility control may have the potential to control
diseases such as bovine tuberculosis in brushtail possums, although the potential of
fertility control techniques to change disease transmission coefficients and disease
epidemiology requires further investigation. This would require models that exam-
ine the combined effects of fertility control on population dynamics, social behaviour
and disease transmission coefficients simultaneously.
Key-words: epidemiology, Leptospira interrogans, modelling, Mycobacterium bovis,
Trichosurus vulpecula.
Journal of Applied Ecology (2001) 38, 1362–1370
Based on the projections of host–pathogen models,
reducing susceptible host abundance is often proposed
as a strategy for eradicating diseases from wildlife
populations, such as Mycobacterium bovis (Karlson &
Lessel) infection (bovine tuberculosis) in brushtail
possums Trichosurus vulpecula (Kerr) (Barlow 1991b,
1996; Roberts 1996) and badgers Meles meles (L.)
(White & Harris 1995), and Brucella abortus infection
(brucellosis) in bison Bison bison (L.) (Dobson &
Meagher 1996). Indeed, reducing the population den-
sity of animals is one of the most frequently attempted
management strategies for controlling disease in wild
animals (Wobeser 1994). This logically follows from
the paradigm of threshold density for the establish-
ment and persistence of disease (Kermack & McKen-
drick 1927; Anderson & May 1979; May & Anderson
1979) and the implicit assumption underlying this par-
adigm that disease transmission scales positively with
abundance. However, the projections of these host–
pathogen models are greatly affected by the way in
which transmission between infected and susceptible
hosts is modelled (McCallum, Barlow & Hone 2001).
Estimating disease transmission coefficients is con-
sidered to be a very difficult parameter estimation
problem (Anderson & May 1991) and remains a great
challenge in field ecology today (McCallum, Barlow &
Hone 2001). Disease transmission coefficients are
model-dependent, and an important issue is the form
of the model for the scaling between host population
density and parasite transmission rate (McCallum,
Correspondence: P. Caley, Landcare Research, Private Bag
11052, Palmerston North 5301, New Zealand (fax + 64 6355
9230; e-mail firstname.lastname@example.com).
Page 2
Estimating disease
transmission rates
© 2001 British
Ecological Society,
Journal of Applied
Ecology, 38,
Barlow & Hone 2001; Grenfell & Bolker 1998 and ref-
erences therein). Resolving this issue can be considered
a model-selection problem for which Akaike's infor-
mation criterion (AIC) provides an approach for
choosing between competing models of transmission
(Burnham & Anderson 1998), providing data sets exist.
Studies that estimate transmission coefficients for
diseases of free-living vertebrates, let alone estimate
the effect of management on disease transmission, are
uncommon in both the laboratory (Bouma, De Jong &
Kimman 1995) and the field (Hone, Pech & Yip 1992;
Swinton et al. 1997; Begon et al. 1999). A result of this
is a general paucity of data on transmission rates (De
Leo & Dobson 1996).
Reducing susceptible host abundance and/or popu-
lation density may be achieved by a variety of means,
such as lethal control, vaccination or reducing fertility
(fertility control). Fertility control has been proposed
as an alternative non-lethal tactic for reducing the
abundance of species such as brushtail possums (Bar-
low 1996; Cowan 1996; Barlow, Kean & Briggs 1997)
and badgers (Swinton et al. 1997; Tuyttens & Macdon-
ald 1998) below the threshold for disease (M. bovis)
persistence. Here, fertility control is broadly defined as
a reduction in the birth rate that should decrease the
rate of population increase, assuming no compensa-
tory change occurs in the death rate (Hone 1992). The
possibility that population control may cause a change
in transmission coefficients through effects on social
behaviour is receiving increasing theoretical interest.
For example, social perturbation arising from lethal
control of badgers may act to promote transmission of
M. bovis (Swinton et al. 1997). In contrast, Tuyttens &
Macdonald (1998) considered that fertility control
(sterilization) of badgers could reduce vertical trans-
mission of M. bovis, and transmission of M. bovis
during mating through changed behaviour.
Endemic M. bovis infection in New Zealand possum
populations is the single biggest threat to the nation's
livestock industry, with M. bovis-infected possums
occurring over about 24% of the land mass (Coleman &
Caley 2000). The presence of this wildlife reservoir of
M. bovis infection has hampered efforts at controlling
the disease in livestock (O'Neil & Pharo 1995; Coleman
& Caley 2000), similar to the problem encountered in
England (Zuckerman 1981) and Ireland (OMairtin
et al. 1998a,b) arising from M. bovis-infected badgers.
While reducing abundance by non-selective culling is
presently the primary strategy for controlling M. bovis
infection in brushtail possum populations in New Zea-
land (Barlow 1991b; Caley et al. 1999), fertility control
is being pursued as an alternative method of reducing
abundance (Cowan 1996, 2000). Methods of fertility
control that block fertilization, such as immunocontra-
ception, may leave the endocrine system intact. Thus
sterile but hormonally competent females may have
an increased frequency of mating contacts due to an
increased frequency of oestrus, as observed in white-
tailed deer Odoicoileus virginianus (Miller) (McShea
et al. 1997) and elk Cervus elaphus (Bailey) (Heilmann
et al. 1998) subjected to this type of contraception.
This prediction is supported for brushtail possums by a
field trial by Ji, Clout & Sarre (2000). Whilst increased
frequency of mating could enhance the transmission
of a hypothetical transmissible biocontrol vector in
brushtail possums (Barlow 1994), it could possibly also
increase the transmission coefficient of M. bovis, thus
negating some of the benefits of reduced abundance
resulting from fertility control. Alternatively, methods
of fertility control that target endocrine control of
reproduction may result in behavioural changes, in-
cluding inhibition of mating behaviour. For brushtail
possums this could mean reduced sexual contacts and
possibly also reduced agonistic contacts, which would
be associated with a reduction in disease transmission.
Clearly, altered behaviour arising from fertility control
techniques potentially may help or hinder disease man-
agement in wildlife, although little attention has been
given to altering high risk behaviour of wildlife to
reduce disease transmission. This is in contrast to the
management of disease in humans, where behaviour
modification (e.g. changing sexual habits in the case of
sexually transmitted diseases) is one of the most com-
monly used methods of management of public health
(Anderson & May 1991; Morris 1996).
In this paper, we present methods for estimating
disease transmission coefficients in wildlife, using
Leptospira interrogans serovar balcanica (Kmety &
Dikken 1993) (hereafter L. balcanica) infection in
brushtail possums as a model system. We compared
two models of transmission (density-dependent and
frequency-dependent) and used the selected best
model to estimate from a field experiment the effect of
behavioural changes induced by fertility control (here
tubally ligating female possums) on the transmission of
disease. We then examined the theoretical implications
of attempting to use fertility control to manage M. bovis
infection in brushtail possums.
Materials and methods
The ability of a pathogen to establish and persist in
animal populations is largely determined by the basic
reproductive rate of the disease (Ro). This is defined as
the expected number of secondary infections caused in
an entirely susceptible population by a typical infected
host. By definition, if Ro is greater than or equal to
unity the disease will establish and, conversely, if Ro is
less than unity the disease will fail to establish (Ander-
son & May 1991). We use a simplified version of the
compartment model for a directly transmitted disease,
as presented by Anderson & May (1979), to illustrate
the possible effects of fertility control relative to that of
culling and vaccination. We choose a model with hor-
izontal transmission, a negligible latent period and no
Page 3
P. Caley &
D. Ramsey
© 2001 British
Ecological Society,
Journal of Applied
Ecology, 38,
life-long immunity. Host population dynamics assume
exponential population growth, with the exponential
rate of increase r = a – b, where a and b are the instan-
taneous per capita birth and death rates, respectively.
Note that this is an illustrative example, rather than an
exact description of the dynamics of infection. Under
this model, mixing is assumed to be homogenous and
hence transmission is 'density-dependent', occurring
at a rate βSI, where β is the disease transmission coef-
ficient and S and I are the abundance of susceptibles
and infectives, respectively. Ro is estimated as:
eqn 1
where α is the per capita disease-induced death rate, b is
the per capita natural death rate, v is recovery rate from
disease, and N is the initial size of the susceptible pop-
ulation. Equation 1 can be interpreted as an infected
animal making β infectious contacts per unit time with
N susceptibles for its life expectancy. Life expectancy is
the reciprocal of the combined mortality rate due to
natural causes and disease. By setting Ro equal to unity
in equation 1, the threshold density (KT) for disease
establishment is found:
eqn 2
The approximation of density-dependent transmission
is reasonable for many directly transmitted diseases,
but may not be adequate for sexually transmitted dis-
eases, for example, where the number of sexual partners
(η) is independent of the absolute population size and
hence no threshold abundance exists (May & Anderson
1979). In this situation, the transmission rate may
be approximated by βηSI/N (May & Anderson 1979),
or here by β′SI/N (replacing βη with β′). This
model of transmission (commonly termed 'frequency-
dependent' transmission; Begon et al. 1999; McCallum,
Barlow & Hone 2001) is most appropriate for diseases
transmitted through contacts that are largely density-
independent (e.g. mating). However, De Jong, Diek-
mann & Heesterbeek (1995) and Bouma, De Jong &
Kimman (1995) suggest that frequency-dependent
transmission may have wider application to host–
pathogen systems where disease contact rates are
not necessarily density-independent. For frequency-
dependent approximation of the transmission process,
the maintenance of disease is independent of the pop-
ulation size, and occurs when β′ > (b + α + v) (May &
Anderson 1979). It follows that the basic reproductive
rate may be calculated (Roberts & Heesterbeek 1993;
Heesterbeek & Roberts 1995) as:
eqn 3
which is independent of population size or density.
We use equations 1, 2 and 3 to investigate qualitat-
ively the possible effects of fertility control-induced
behaviour change on disease. Under density-dependent
transmission, Ro is decreased by either reducing
the numerator (βS), increasing the denominator
(α + b + v) or reducing βS by proportionally more than
(α + b + v) is reduced. For example, culling of possums
aims to increase the mortality rate (b) and reduce the
abundance of susceptible possums (S), both of which
act to lower Ro. Vaccination also acts to reduce the
abundance of susceptible possums; in effect, vaccinated
possums are removed from the susceptible population,
thus reducing S. Equation 3 makes the important
prediction that for frequency-dependent transmission,
disease may only be controlled by increasing the
mortality rate (assuming β′, α and v are constants).
Equations 1, 2 and 3 clearly illustrate that wildlife
management could target the actual mechanisms of
disease transmission that make up β as an alternative
to targeting hosts per se. Historically, β is considered
difficult to measure, as it subsumes many processes
involved in initiating infection (Anderson & May
1991). Additionally, β is model-specific. So, given a
model, how do we estimate the transmission coefficient
from field data? For simplicity, we consider our simple
disease–host model where the transmission of disease
is either frequency-dependent or density-dependent.
Under density-dependent transmission, susceptibles
are infected at rate βSI, hence the per capita instanta-
neous incidence of disease (λ), termed the force of
infection (Muench 1959), equals βI, and β can be sim-
ply expressed in terms of the abundance of infectives
and the force of infection:
eqn 4
A similar argument gains an expression for β′ in terms
of prevalence (p):
eqn 5
Importantly, equations 4 and 5 show that under the
simple models chosen, β and β′ may be calculated from
the force of infection and the abundance of infectives.
This is done below for L. balcanica infection in brush-
tail possums.
To determine if methods of fertility control that block
fertilization (e.g. immunocontraception) could result
in behavioural changes affecting the transmission coef-
ficient β, we undertook an experiment to estimate the
transmission rate of L. balcanica in wild populations
of the brushtail possum subject to fertility control
(tubal ligation of females). Leptospira balcanica is a
commonly occurring disease in possums thought to be
transmitted predominantly by sexual contact (Durfee
& Presidente 1979; Day et al. 1997, 1998). Clinical
disease due to L. interrogans infection in most wild
animals is rare (Bender & Hall 1996) and no clinical
′ =
Page 4
Estimating disease
transmission rates
© 2001 British
Ecological Society,
Journal of Applied
Ecology, 38,
symptoms were observed in possums infected with
L. balcanica in a study by Hathaway (1981). The
hypothesis tested in the present study was that im-
munocontraception as modelled by tubal ligation
increased frequency of oestrus in sterilized females,
leading to increased mating contacts with males, result-
ing in a higher transmission coefficient for L. balcanica.
Increased frequency of oestrus in tubally ligated
captive female possums has been demonstrated ex-
perimentally in both captive (Rekha 1997) and
free-ranging (Ji, Clout & Sarre 2000) possums.
The experiment formed part of a larger study to
determine the effects of various levels of fertility con-
trol on the population dynamics of brushtail possums
(Ramsey 2000). Four live-trapping grids were estab-
lished in podocarp/broadleaf forest in the lower North
Island of New Zealand, two in the Orongorongo Valley
(separated by c. 500 m), east of Wellington (174°58′ E,
41°21′ S), and two in the Turitea catchment (separated
by c. 1 km), east of Palmerston North (175°41′ E,
40°26′ S). Each grid consisted of 150 cage traps set at
30 m spacing. Sites were established in October 1995
and trapped three times yearly in January, June and
September. Experimental treatments, consisting of
either 0% (although with 80% of females subject to
sham operations) or 80% of mature females surgically
sterilized by tubal ligation, were applied randomly to
the two blocks in the Orongorongo Valley and the two
blocks in the Turitea catchment between January–
April 1996. Each year the number of sterilized females
was adjusted to maintain the 80% sterility level. Move-
ment of animals between grids at each location was
On first capture, possums were anaesthetized with
ether and given a unique tattoo and ear tag for identi-
fication. During the June trapping sessions from years
1996–99, c. 5 ml of blood was collected from 60–100
possums on each of the experimental control (0%
sterilized) and 80% treatment grids. The June trapping
period was selected for sampling as it occurs directly
after the main autumn breeding period of March–June
(Fletcher & Selwood 2000). The serum was separ-
ated by centrifugation and submitted to the Central
Animal Health laboratory, Wallaceville, New Zealand,
for serology. The serological micro-agglutination test
(MAT), using doubling dilutions of serum beginning at
1 : 50, was used to detect the presence of leptospiral
antigens (Horner, Heath & Cowan 1996). If no reaction
was seen in the 1 : 50 dilution, the result was scored as
negative. A positive result indicated the presence of
active leptospiral infection (Cowan, Blackmore &
Marshall 1991).
For testing the effect of sterilization treatment on the
transmission coefficient for L. balcanica infection of
possums, we assume that the force of infection is con-
stant within years (although not necessarily between
years) with no disease-induced mortality (α = 0). This
allows us to use the very tractable exponential dis-
tribution (Lee 1992) to model the force of infection
observed in the experiments. Over n intervals of length
ti, each having a force of infection λi and abundance of
infectives Ii, the probability of an individual acquiring
infection (p) is given by:
eqn 6
The force of infection is the parameter of interest in
many studies of disease (McCallum 2000); however,
here it is the transmission coefficient that is of intrinsic
interest. Substituting for λ from equation 4 into equa-
tion 6 and rearranging equation 6 yields an expres-
sion for the observed probability of infection (p) under
density-dependent transmission in terms of the trans-
mission coefficient (β) and the abundance of infectives
(Ii) in each time interval (ti):
eqn 7
Likewise, for frequency-dependent transmission, sub-
stituting for λ from equation 5 into equation 6 gives an
expression for the observed individual disease preva-
lence in terms of transmission coefficient (β′) and the
prevalence of infectives (Zi) in the population during
each time interval (ti):
eqn 8
Equations 7 and 8 are generalized linear models
(GLM) that enable direct estimation of the transmis-
sion coefficients, and testing of the effect of sterility
control treatment on them. They are somewhat similar
in structure to the GLM presented by Becker (1989) for
estimating β from an outbreak with complete observ-
ability (i.e. a notifiable disease with all cases reported
and total population known). The key difference is
that, rather than having a known absolute number of
cases during the experiment, in our experiment we
have a sampled proportion of new-case individuals,
hence our data are binomially rather than normally
Equations 7 and 8 were fitted to the incident cases of
L. balcanica that occurred during the experiment using
a GLM utilizing a complementary log–log link, and
the logarithmic term on the right-hand side of each
equation fitted as an offset (equivalent to fixing the
slope of the regression to 1; Collett 1991). The response
variable was the number of incident cases of disease
during the experiment with the binomial denominator
equal to the number of individuals tested. Individuals
who were seropositive on their first sample were dis-
carded from the analysis, except when calculating the
overall prevalence of disease (Zi). The exceptions were
animals that showed a greater than twofold increase in
antibody titre between serum samples. In studies on
captive animals, L. balcanica infection in possums was
i i
ln( ln(
)) ln ln
pI t
i i
ln( ln(
)) ln ln
′ +
p Zt
i i
Page 5
P. Caley &
D. Ramsey
© 2001 British
Ecological Society,
Journal of Applied
Ecology, 38,
followed by a peak in antibody titres within a month of
infection (Hathaway 1981). Antibody titres then slowly
decreased over the following 13 months. The most
likely explanation for a large (> 2 doubling dilutions)
increase in antibody titres between annual serum sam-
ples, therefore, is that the individual had been recently
re-exposed to infection. The treatment 0% or 80% ste-
rility was fitted as a factor. The abundance of infectives
on each grid in each year (I) was estimated from the
sampled prevalence of disease, and the abundance of
possums estimated using the jack-knife estimator
(Burnham & Overton 1978). Time at risk (t) for an indi-
vidual was defined as the period from the date of first
capture or the date of application of treatments for pos-
sums resident before the start of the study to the date of
last serum sampling. Locality (Orongorongo Valley or
Turitea) was fitted as a fixed block effect in all models.
The competing hypotheses of density-dependent vs.
frequency-dependent transmission, as represented by
equations 7 and 8, were compared by calculating AIC
scores for each, with the best model selected being that
with the lowest AIC score (Burnham & Anderson
1998). All statistical analysis was performed in S-plus
version 2000 (Mathsoft, Seattle, WA).
A summarized form of the data used to estimate dis-
ease transmission coefficients is shown in Table 1. The
point prevalence of L. balcanica infection was high
although variable (mean = 55·2%, range 38·8–70%),
as was the abundance of possums on each trapping grid
(mean = 148, range 63–257). The incidence of L. bal-
canica was estimated from 213 possums with more than
one serum sample. Of these 213 possums, 30 of 103
possums in experimental control sites, and 39 of 110
possums in the sterility sites, sero-converted during
the course of the study (Table 1).
The model assuming density-dependent transmis-
sion was most strongly supported by the data, based on
having the lowest AIC (Table 2). However, we present
the results of both models as, based on a ∆AIC of 3, the
model assuming frequency-dependent transmission is
bordering on having substantial support in compar-
ison (Burnham & Anderson 1998). There was little
evidence from either model that the transmission
coefficient differed between geographical locality (density-
dependent P = 0·77, frequency-dependent P = 0·22),
so this variable was removed from the models. Assum-
ing density-dependent transmission, β was estimated
to be 1·3 times higher in the 80% sterility sites than the
experimental control sites, although there remained
doubt as to the probability that this was a true treat-
ment effect (P = 0·16; Table 2). Estimates of β′ under
the frequency-dependent transmission model were
1·24 times higher for possums in the 80% sterility sites
than for possums in the experimental control sites
(Table 2).
With negligible disease-induced mortality (α = 0),
no disease recovery (v = 0) and natural instantaneous
mortality rate (b) for adult possums of 0·24 year–1
(Efford 1998), the threshold abundance for the estab-
lishment for L. balcanica infection in brushtail pos-
sums is estimated to be 96 possums for unmanipulated
populations, and 75 possums with 80% tubal ligation
of females, a reduction of 16%. For the grid size used
in our study with an effective trapping area of c. 22 ha
(D. Ramsey, unpublished data), the corresponding
population densities for disease establishment are
4·4 possum ha–1 for unmanipulated populations and
3·4 possum ha–1 for populations subject to 80% tubal
ligation of females.
Table 2. Parameter estimates from generalized linear models fitted to incident cases of Leptospira balcanica in possums subject
to 0% or 80% sterilization of females, assuming density-dependent (transmission type βSI) or frequency-dependent (transmission
type β′SI/N) disease transmission. The parameter estimate for '+ Sterility' is the contribution of the 80% sterility treatment to
ln(β). P-values are for one-tailed tests. ∆AIC gives the comparative AIC scores for the two models
Transmission typeModel parameters Parameter estimateSE
+ Sterility
+ Sterility
*Standard normal deviate.
Table 1. Prevalence of Leptospira balcanica (Zˆ ), estimated
possum abundance (N), number of possums at risk of
infection that were sampled (S), and the number of incident
cases of Leptospira balcanica (I) for different levels of sterility
Treatment SiteYear
0% sterility Turitea
80% sterilityTuritea


text:
Rate of Jewish Immigration to Israel Leveling Off
A total of 16,577 people immigrated to Israel in 2012, according to recently released figures from the Central Bureau of Statistics.
The rate of immigration to Israel has steadied in recent years, because Diaspora Jews face less pressure to leave their home countries for security or economic reasons, demographers say.
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subset: commoncrawl


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Results 1 to 5 of 22
Thread: Mini Challenge- Lah di dah
October 7th, 2013 05:11 PM #1
Mini Challenge- Lah di dah
I just tried to make triplets out of the initials
and it was pretty difficult. So...I'm putting a mini challenge to the berries to create the best sibset out of these initials. Then I will make a poll to crown the winner.Nameberry Combos 2015 Results
October 7th, 2013 07:05 PM #3
October 7th, 2013 07:38 PM #5
October 7th, 2013 07:46 PM #7Zelia • XXI • History student • Film and royalty enthusiastI blog at vesperlynds and everythingroyalty, and export names from Greenland and Inuit mythology
Henry Ásgeirr Edmund • Alexander Adelin Lórien "Sasha" • Asa Archibald Ivik • Atticus Aksel Inigo
Cosima Ingrid Zenobia "Mimi" • Asta Ivalo Galadriel • Aviaaja Catherine Françoise "Avi" • Anna Margaret Undómiel "Anoushka"
GPs: Nor Aurvandil James "Jem" • Dante/Frej Valdemar Oisín • Olga Agnes Lúthien • Evelyn Alvaret Cleopatra "Elví"
October 7th, 2013 08:16 PM #9Not expecting, just having fun collecting names!
My name is Erin. I am 23 years old and I have been a proud name nerd since I was 10.
Ladies: Juliet Elaine, Madeleine Rachel, Marie Anneliese, Linnea Carys, Maisie Rose, Emilia Noelle, Clara Felicity, Lydia ?, Elise Victoria, Evelyn
Gentlemen: Jonathan Rhys, Wesley Jude, Roman Gabriel, Evan Connor, Quentin Oliver, Dawson Cole, Jude Nathaniel, Rhys Anthony, Ciaran Matthew, Everett Jacob


text:
- Age / Gender:
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Love music, love gaming, love to write. I drew my icon and main picture. Any questions?
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ascend Rated 3.8352 Stars A short platformer about loss. Action - Platformer - Other Light Cut Rated 3.9846 Stars A medic suffering post-traumatic stress from WWII retells his dreams. Simulation - Other Escape from Jay is Games Rated 4.0277 Stars Escape the room. In this case - Jay is Games office. Adventure - Point 'n Click Don't Escape 2 Rated 4.5320 Stars A horde of the undead is near. Can you lock yourself in your hideout and survive...? Adventure - Point 'n Click


text:
Citizen G-Eco Drive Watch
$221.25 Original Price $295.00
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Shipping your purchase is easy on belk.com. Depending on the destination of your package, you can expect it to arrive within 4-7 business days. Shipping Information
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text:
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text:
sirius mt2 how to install
Sirius mt2 how to installat Software Informer
No reviewed programs with such name
More Sirius mt2 how to install
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1 SIRIUS 139 Freeware 48.21 MB
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text:
last weekend in June
- jmbrenma47
- Updated 06/14/2012
- 10 Items
pizza by the slice
Bike-trail treats
Places to get a bite while you're out on your bike
- robpegoraro
- Updated 08/01/2011
- 10 Items
Half a block south of the W&OD Trail. Good, NYC-style pizza by the slice, right down to the grease running down your wrist.
T-day Friday options
Group and kid friendly
- melissa.vannuil
- Updated 11/18/2010
- 3 Items


text:
Dysphagia After Stroke: Incidence, Diagnosis, and Pulmonary Complications
ABSTRACT To determine the incidence of dysphagia and associated pulmonary compromise in stroke patients through a systematic review of the published literature.
Databases were searched (1966 through May 2005) using terms "cerebrovascular disorders," "deglutition disorders," and limited to "humans" for original articles addressing the frequency of dysphagia or pneumonia. Data sources included Medline, Embase, Pascal, relevant Internet addresses, and extensive hand searching of bibliographies of identified articles. Selected articles were reviewed for quality, diagnostic methods, and patient characteristics. Comparisons were made of reported dysphagia and pneumonia frequencies. The relative risks (RRs) of developing pneumonia were calculated in patients with dysphagia and confirmed aspiration.
Of the 277 sources identified, 104 were original, peer-reviewed articles that focused on adult stroke patients with dysphagia. Of these, 24 articles met inclusion criteria and were evaluated. The reported incidence of dysphagia was lowest using cursory screening techniques (37% to 45%), higher using clinical testing (51% to 55%), and highest using instrumental testing (64% to 78%). Dysphagia tends to be lower after hemispheric stroke and remains prominent in the rehabilitation brain stem stroke. There is increased risk for pneumonia in patients with dysphagia (RR, 3.17; 95% CI, 2.07, 4.87) and an even greater risk in patients with aspiration (RR, 11.56; 95% CI, 3.36, 39.77).
The high incidence for dysphagia and pneumonia is a consistent finding with stroke patients. The pneumonia risk is greatest in stroke patients with aspiration. These findings will be valuable in the design of future dysphagia research.
- SourceAvailable from: Simeon Dale
- "Hyperglycaemia following stroke has been shown to increase infarct size (Allport, Baird, & Davis, 2008; Pulsinelli et al., 1983) and lead to poorer outcomes independent of the patient's prestroke history of diabetes (Pulsinelli et al., 1983; Weir et al., 1997). The incidence of dysphagia in the acute poststroke period ranges from 37% to 78% (Martino et al., 2005) and stroke patients with dysphagia are three times more likely to develop pneumonia than those without dysphagia (Doggett et al., 2001; Martino et al., 2005). Thus, optimal management of these three common physiological disturbances, namely, fever, hyperglycaemia and dysphagia are important elements of organised stroke care with potential to significantly influence outcomes. "
Article: Barriers and Enablers to Implementing Clinical Treatment Protocols for Fever, Hyperglycaemia, and Swallong Dysfunction in the Quality in Acute Stroke Care (QASC) Project - A Mixed Methods Study[Show abstract] [Hide abstract]
ABSTRACT: The Quality in Acute Stroke Care (QASC) trial evaluated systematic implementation of clinical treatment protocols to manage fever, sugar, and swallow (FeSS protocols) in acute stroke care. This cluster-randomised controlled trial was conducted in 19 stroke units in Australia. To describe perceived barriers and enablers preimplementation to the introduction of the FeSS protocols and, postimplementation, to determine which of these barriers eventuated as actual barriers. Preimplementation: Workshops were held at the intervention stroke units (n = 10). The first workshop involved senior clinicians who identified perceived barriers and enablers to implementation of the protocols, the second workshop involved bedside clinicians. Postimplementation, an online survey with stroke champions from intervention sites was conducted. A total of 111 clinicians attended the preimplementation workshops, identifying 22 barriers covering four main themes: (a) need for new policies, (b) limited workforce (capacity), (c) lack of equipment, and (d) education and logistics of training staff. Preimplementation enablers identified were: support by clinical champions, medical staff, nursing management and allied health staff; easy adaptation of current protocols, care-plans, and local policies; and presence of specialist stroke unit staff. Postimplementation, only five of the 22 barriers identified preimplementation were reported as actual barriers to adoption of the FeSS protocols, namely, no previous use of insulin infusions; hyperglycaemic protocols could not be commenced without written orders; medical staff reluctance to use the ASSIST swallowing screening tool; poor level of engagement of medical staff; and doctors' unawareness of the trial. The process of identifying barriers and enablers preimplementation allowed staff to take ownership and to address barriers and plan for change. As only five of the 22 barriers identified preimplementation were reported to be actual barriers at completion of the trial, this suggests that barriers are often overcome whilst some are only ever perceived rather than actual barriers. © 2015 Sigma Theta Tau International.Worldviews on Evidence-Based Nursing 01/2015; 12(1). DOI:10.1111/wvn.12078 · 2.38 Impact Factor
[Show abstract] [Hide abstract]
- "Aspiration pneumonia is defined as pneumonia typically bacterial in origin, occurring with patients who are at risk for increased oropharyngeal aspiration (Marik & Kaplan, 2003; Millns, Gosney, Jack, Martin & Wright, 2003). A systematic review of nine studies on dysphagia poststroke, demonstrated that the incidence of pneumonia in poststroke patients with dysphagia ranges between 7% and 33% (Martino et al., 2005). After a stroke, patients are at an increased risk for reduced frequency of oral care and increased oral colonization for various reasons: physical impairment limiting mobility and self-care, decreased coordination of movements , cognitive deficits, dysphagia resulting in decreased salivary and bolus clearance, and medication-related xerostomia (Fitzpatrick, 2000; Talbot, Brady, Furlanetto, Frenkel & Williams, 2005). "
ABSTRACT: PurposeThe pilot study purpose was to determine the effects of a new standardized oral care protocol (intervention) to usual care practices (control) in poststroke patients.DesignThis study is a randomized controlled clinical trial.Method Fifty-one subjects were enrolled. Subjects in the intervention group received oral care twice a day including tooth brushing, tongue brushing, flossing, mouth rinse, and lip care while control patients received usual oral care.FindingsSubjects in the control and intervention groups showed improvement in their oral health assessments, swallowing abilities and oral intake. There were no significant differences between the two groups. Although not statistically significant, overall prevalence of methicillin-resistant Staphylococcus aureus and methicillin-sensitiveStaphylococcus aureus colonization in the control group almost doubled (from 4.8% to 9.5%), while colonization in the intervention group decreased (from 20.8% to 16.7%).Conclusions/Clinical RelevanceThese findings demonstrate the importance of oral care in the poststroke patient with dysphagia.11/2014; 39(6). DOI:10.1002/rnj.154
[Show abstract] [Hide abstract]
- "Many high-risk patients will not complain of dysphagia but still aspirate based on advanced testing [51]. The poststroke population certainly has a higher prevalence of pneumonia with or without symptomatic dysphagia [52] [53]. A lag time of more than 5 seconds between noxious stimuli and cough, as well as an increasing stimuli needed to produce a cough, has been linked to pneumonia in poststroke patients regardless of dysphagia [54]. "
ABSTRACT: Purpose: The purpose was to describe aspiration pneumonia in the context of other lung infections and aspiration syndromes and to distinguish between the main scenarios commonly implied when the terms aspiration or aspiration pneumonia are used. Finally, we aim to summarize current evidence surrounding the diagnosis, microbiology, treatment, risks, and prevention of aspiration pneumonia. Materials and methods: Medline was searched from inception to November 2013. All descriptive or experimental studies that added to the understanding of aspiration pneumonia were reviewed. All studies that provided insight into the clinical aspiration syndromes, historical context, diagnosis, microbiology, risk factors, prevention, and treatment were summarized within the text. Results: Despite the original teaching, aspiration pneumonia is difficult to distinguish from other pneumonia syndromes. The microbiology of pneumonia after a macroaspiration has changed over the last 60 years from an anaerobic infection to one of aerobic and nosocomial bacteria. Successful antibiotic therapy has been achieved with several antibiotics. Various risks for aspiration have been described leading to several proposed preventative measures. Conclusions: Aspiration pneumonia is a disease with a distinct pathophysiology. In the modern era, aspiration pneumonia is rarely solely an anaerobic infection. Antibiotic treatment is largely dependent on the clinical scenario. Several measures may help prevent aspiration pneumonia.Journal of Critical Care 07/2014; 30(1). DOI:10.1016/j.jcrc.2014.07.011 · 2.00 Impact Factor


text:
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text:
ODS is not ready for full on potty training yet, he will pee in the/or his potty anytime you bring him to it or ask him.
But he wears diapers still unless he wants underwear.
When he poops in his diaper he will not tell us and instead Grab his poop....
At first i didn't "punish" him bc I did similar things....? But now He is being punished(timeouts, spanking) everytime. Period.
It's gone way past wanting it out of his diaper.
He does it just about every time unless I see him pooping.
What should I do? Me and DH are lost.
It's almost instantly after pooping the hands in diaper.
I plan on just taking diapers away (except sleep) in April.
Also my mom said something about regressing because of YDS. He was 9.5 months.....and def doesn't do anything like this.
But I do think it has something to do with wearing diapers. He says "my diaper, baby's diaper"
And wants me to put him in one when changing YDS.
Sorry for any typos. On my phone(:


text:
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Booster Car Seat
Pet Gear Booster / Carrier / Car Seat is a great way to travel in your car while comfortably securing your pet. It can be used flat on the car seat or it can be boosted up to give your pet a view out the window by strapping the shoulder harness around the head rest. It has several pockets for your leash, snacks or other pet needs. Ideal for pets up to 18-pounds.
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|15 x 12.5 x 9.5 inch
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Product NotesView All Pet Gear View All Carriers & Gear
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Please contact us at 1-866-SHOP-WAG (1-866-746-7924)


text: "It was fun last year," Mason said. "After growing up here then playing for your home team, coming to camp and being star-struck by all the great veterans you use to watch on TV. Now I am just out here trying to get a spot. I want to do better than the practice squad."


text:
To make reservations by phone, call 1-800-228-2800 in the USA and Canada (or any of our worldwide reservation telephone numbers).
It Pays to Book Direct™
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text:
|Publication number
|Publication type
|Application number
|Publication date
|Jun 12, 1979
|Filing date
|May 9, 1977
|Priority date
|May 9, 1977
|Also published as
|Publication number
|Samuel R. Schuster, Louis Kopito, Harold Kosasky
|Original Assignee
|Ovutime, Inc.
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (9), Non-Patent Citations (1), Referenced by (65), Classifications (11), Legal Events (3)
|External Links: USPTO, USPTO Assignment, Espacenet
1. Field of the Invention
The present invention relates to the medical testing of cervical material, i.e. tissue and/or mucus, and more particularly to the routine collection of cervical material via the vaginal cavity in such a way that the cervical specimen is unaffected by contact with the vaginal wall.
2. The Prior Art
In the past, it usually has required skilled medical personnel to obtain useful samples of cervical material. In one form, such cervical material is tissue from the cervical os, which is tested for malignancy in the form of a pap smear. In another form, such cervical material is mucus from the cervical os, which indicates ovulation when of predeterminedly low viscosity and the absence of ovulation when of predetermined high viscosity, for fertility control. Previously proposed probes, by which cervical material may be collected, examined and tested, generally have not been for self-use by women wishing to retrieve cervical specimens. It is desired to retrieve such cervical specimens by a reliable probe, which does not require a skilled medical operator but rather which can be operated by the subject woman herself. The probe of the present invention thus enables any woman to submit self-obtained cervical tissue specimens to the laboratory for microscopic examination or to subject self-obtained cervical mucus to rheological testing in simple equipment available in the home for fertility control.
The primary object of the present invention is to provide a probe for inserting a test element into the vaginal cavity while shielding it from intermediate vaginal contact, for positioning the test element precisely in contact with the cervical os in order to collect a specimen of cervical meterial, and for retrieving the test element and the specimen from the vaginal cavity while shielding them from intermediate vaginal contact. The design of this probe is based in part upon two considerations. The first consideration is that, in most women, the distance between the cervical os and posterior fornix is approximately the same, viz. 1 to 5 centimeters. The second consideration is that, in order to achieve the most accurate test results, it is often desirable that the cervical material be undisturbed by transfer from one mechanical device to another, for example from a first test support to a second test support. It is desirable particularly that the collection of cervical mucus, which at times other than during mid-cycle is very sparse, may be made directly on the final test support. In accordance with the present invention, the probe preferably comprises a test element for collecting a specimen by direct contact with the cervical os, a sheath within which the test element is confined during insertion into the vaginal cavity, a foot at the forward extremity of the sheath, which enables repeated positioning of the sheath predeterminedly within the vaginal cavity, and a manual control for directing the test support from within the sheath into contact with the cervical os and from contact with the cervical os back into the sheath. Thus, removal of the instrument from the vaginal cavity achieves isolation of the test support within the sheath during removal of the sheath from the vaginal cavity.
Other objects of the present inventions will in part be obvious and will in part appear hereinafter.
The invention accordingly comprises the devices and processes herein disclosed, together with their parts, steps and interrelationships, the scope of which will be indicated in the appended claims.
For a fuller understanding of the nature and objects of the present invention, reference is made to the following detailed description, which is to be taken in connection with the accompanying drawings, wherein:
FIG. 1 is a sagittal view of the human female anatomy in the vicinity of the cervix;
FIG. 2 is a perspective view of a device embodying the present invention in a first operative condition;
FIG. 3 is a perspective view of the device of FIG. 2 in a second operating condition;
FIG. 4 is a perspective view of the device of FIG. 2 in a third operating condition;
FIG. 5 is a longitudinal, cross sectional view of the device as shown in FIG. 2;
FIG. 6 is a longitudinal, cross sectional view of the device as shown in FIG. 3;
FIG. 7 is a longitudinal, cross sectional view of the device as shown in FIG. 4;
FIG. 8 is a front view of the device as shown in FIGS. 2 and 5;
FIG. 9 is a perspective view of a component of the device of FIGS. 2 to 7, in operative relation to a component of a test apparatus;
FIG. 10 is a side view of a modification of a component of the device of FIGS. 2 to 7, in a first operating condition;
FIG. 11 is a side view of a component of FIG. 9, in a second operating condition;
FIG. 12 is a side view of another modification of a component of the device of FIGS. 2 to 7, in a first operating condition; and
FIG. 13 is a side view of the component of FIG. 12, in a second operating condition.
FIG. 1 anatomically illustrates details of the uterus 20 and the vaginal wall 22. Uterus 20 includes the uterine fundus 24, the cervix 26, the portio vaginalis 28 and the cervical os 30. The posterior fornix 32 between the most distal portion of the portio vaginalis and the posterior vaginal wall is of particular interest in accordance with the present invention. It has been found that the geometrical distance, between a plane 34 containing the end of the posterior fornix and a plane 36 containing the cervical os, ranges from 1 to 5 centimeters in almost all normal women. The test probe now to be described relies upon that anatomical fact.
With reference now to FIGS. 2 and 5, the illustrated probe, shown generally at 40, comprises an outer sheath 42, an intermediate tube 44 slidable therewithin and an inner shaft 46 slidable therewithin. Sheath 42, tube 44 and shaft 46, in effect, are outer, intermediate and inner telescoping members, all of which are predeterminally shaped to serve interrelated functions. The purpose of these interrelated functions is to collect mucus from the cervical os on a test support 76, which, as shown in FIG. 9, is in the from of a ridged element 79 that is adapted for contact by a cross-ridged element 81 in such a way that the pulling force necessary to cause separation of the ridged elements is a function of rheological properties. Such a system is described in detail in U.S. Pat. No. 3,926,037, issued Dec. 16, 1976 and U.S. Pat. No. 4,002,056, issued Jan. 11, 1977.
Sheath 42, which is composed of a thin semi-rigid polymer, such as polyethylene or polyethylene terephtalate, includes a forwardly projecting reference foot portion 48, a transversely shaped intermediate mouth portion 50, a rearwardly extending tubular body portion 52, and a rearward flange poriton 54.
In accordance with the present invention, reference foot portion 48 ranges in length from 1 to 5 centimeters so that, when the instrument is inserted into the vagina, the reference foot portion moves along the inferior vaginal wall until seated in the posterior fornix, which serves as a reference point that limits further insertion. Reference foot portion 48 has a narrow forward extremity 56 that is shaped to contact the end 32 of the posterior fornix, a convex under surface 58 that is shaped to rest against the posterior vaginal wall and a concave upper surface 60 that is shaped to rest beneath the most distal portion of the portio vaginalis. Intermediate mouth portion 50 includes an upwardly directed surface that is severed into sections by intersecting slits 61, 62, 63, 64, which extend longitudinally along body portion 42 and meet in the vicinity of the center of mouth portion 50. These severed sections constitute a mouth with flexible flaps that tend to remain closed normally but that can be opened from inside the sheath in a manner to be described below.
Intermediate tube 44 has an outside diameter that is slightly less than the inside diameter of body portion 52 of sheath 42 so as to be slidable within body portion 52. Tube 44 has an open forward end 66, an intermediate inwardly directed annular rib 68, an outwardly directed stop flange 70 and an outwardly directed manual flange 72. As shown in FIGS. 3 and 6, when flange 70 of tube 44 is in abutment against flange 54 of sheath 42, forward extremity 66 of tube 44 projects through mouth portion 50 to expose the front end of inner shaft 46. It will be observed that, when in the condition shown in FIGS. 2 and 5, sheath 40 is capable of being inserted through the vaginal cavity so that extremity 48 seats against end 32 of the posterior fornix and so that mouth portion 50 is adjacent to cervical os 30. Preferably tube 44 is composed of a semi-rigid material such as polyethylene or polyethylene terephthalate.
Shaft 46 includes: a forward portion 74, which is recessed to seat a test element 76; a body portion 78, which slides within annular rib 68; and a rearward handle portion 80 that slides within tube 44. The outside diameter of body portion 78 is slightly less than the inside diameter of annular rib 68. The outside diameter of rearward handle 80 is slightly less than the inside diameter of tube 44. The forward portion of shaft 78 has a natural curve which causes it to bend upwardly when it is not confined within tube 44. When rearward portion 80 of shaft 46 is pressed inwardly against the bias of compression spring 82, the forward face of test support 76 is pressed against cervical os 30. Preferably shaft 46 is composed of a semi-rigid material such as polyethylene or polyethylene terephthalate.
In operation, first device 40, as shown in FIG. 2, is inserted into the vaginal cavity in such a way the reference foot portion 48 moves continuously along the inferior vaginal wall until the instrument can be inserted no farther. At this point, forward extremity 56 is seated at the end 32 of the posterior fornix, which is the reference point for operation of the instrument. Next, manual pressure is exerted between fingers against flange 54 and thumb against flange 72 to cause flange 70 to abut against flange 54 and forward extremity 66 of tube 44 to project through mouth 50. Next, manual pressure on rearward portion 80 of shaft 46 against the bias of spring 82 causes the forward portion of shaft 46 to project from tube 44 and a forward surface of test support 76 to abut against cervical os 30. Next, the pressure on rearward portion 80 of shaft 46 is released to permit spring 82 to retract forward portion 74 and test support 76 into tube 44. Then, tube 44 is retracted so that its forward portion recedes through mouth 50 of sheath 52. Finally, the entire device is removed from the vaginal cavity. The arrangement is such that test support 76 now can be removed from within the device in such a way as to permit cervical mucus thereon to be tested.
A modification of a component of the device of FIGS. 3 to 7 is shown in FIGS. 10 and 11. FIGS. 10 and 11 show the forward extremity of a shaft 82 which can be substituted for shaft 46, of the above described embodiment. Here shaft 82, which does not have a natural curved forward portion, is straight and has at its forward extremity a test element 84. Test element 84 is pivoted to shaft 82 at 86. Test element 84 is of sufficiently small cross sectional dimension to slide with the end of shaft 82 into and out of tube 44. When test element 84 is projected forwardly into contact with the anterior lip 90 of the portio vaginalis, it pivots in a clockwise direction in such a way that its test surface 92 contacts cervical os 30. When in this operative condition, test surface 92 collects cervical mucus or tissue from the cervical os. The operation of the illustrated device with the modification shown in FIGS. 10 and 11 is substantially the same as the operation of the embodiment of FIGS. 2 to 7 described above.
In another modification, as shown in FIGS. 12 and 13, test element 76 is replaced by a sponge 94 that is composed of a resilient polymeric foam. The sponge is sufficiently resilient to expand when protruded from tube 44 and to contract when retracted into tube 44. Sponge 94 is designed to abrade the cervix in the vicinity of the os in such as way that, when rotated as in FIG. 13, its serrated surface scrapes and collects tissue for later microscopic examination. The operation of this modification is otherwise substantially the same as the operation of the embodiment of FIGS. 2 to 7 described above.
Since certain changes may be made in the foregoing disclosure without departing from scope of the invention hereof, it is intended that all matter described in the foregoing specification or shown in the accompanying drawings be interpreted in an illustrative and not in a limited sense.
|Cited Patent
|Filing date
|Publication date
|Aug 25, 1927
|Feb 26, 1929
|Wappler Reinhold H
|Blunted endoscope
|Jul 7, 1932
|Nov 26, 1935
|Frederick C Wappler
|Therapeutic applicator device
|Nov 1, 1937
|Dec 26, 1939
|Glass Edwin B
|Rectal electrode
|Jan 26, 1946
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|Mar 24, 2004
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|May 28, 2004
|Mar 17, 2005
|Maginot Thomas J.
|Catheter systems and associated methods
|May 28, 2004
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|Methods of performing medical procedures with catheter systems having movable member
|Aug 3, 2005
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|Apparatus for delivering endoluminal prostheses and methods of making and using them
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|Apr 15, 2010
|Stephen George Edward Barker
|Medical Instruments
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|System and method for determining structural characteristics of an object
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|Dec 3, 1985
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|Mar 11, 1996
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|U.S. Classification
|600/572, 604/158, 604/14
|International Classification
|Cooperative Classification
|European Classification
|Nov 23, 1981
Owner name: REPRO TECHNOLOGY INC., 115 CLAREMONT ST., NEWTON,
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNOR:OVUTIME, INC.;REEL/FRAME:003930/0600
Effective date: 19801117
|Jan 27, 1984
Owner name: BANK OF NEW ENGLAND, N.A.
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text:
Sephora Eyeliner
75 reviews
57% would repurchase
Package Quality: 3.3
Price: $
Package Quality: 3.3
Price: $
on 10/30/2003 2:32:00 PM
Age: 19-24
Skin: Combination, Fair-Medium, Cool
Hair: Brunette, Straight, Fine
Eyes: Blue
Great price and color selection for these pencils, but I'm sorry to say that I can't work up too much enthusiasm for the quality. The color managed to last a reasonable amount of time (6 hours or so) but they creased and smudged quite a bit on the lower lid and I had a hell of a time putting it on. The pencil was hard, and I had to run the tip under hot water to get it to soften up any. Even after that I had to drag the pencil over and over again to get any color to transfer. I won't be reaching for this pencil often, but I might repurchase again anyway if there was a color I absolutely had to have.
on 10/23/2003 3:02:00 AM
Age: 30-35
Skin: Combination, Fair-Medium, Not Sure
Hair: Black, Other, Other
Eyes: Brown
I have the color brown. The texture is really rough like drawing with a pencil on the skin. The color fades quickly and needs re-applying after a few hours. After several applications, I decided it's not worth it. I bought an Origins eyeliner which is fabulous.
on 8/12/2003 6:07:00 AM
Age: 18 & Under
Skin: Combination, Fair-Medium, Not Sure
Hair: Brunette, Other, Other
Eyes: Brown
I used this eyeliner in black. By far the best pencil eyeliner I've found in a while. Goes on smooth and very dark. Definitely would buy again!
on 6/30/2003 6:33:00 PM
Age: 25-29
Skin: Normal, Other, Not Sure
Hair: Blond, Other, Other
Eyes: Blue
This is great if you are looking to try a new color or play with a trend. However, its smooth texture makes it easy to apply but also easy to smudge and almost always ends up on my upper lid in the crease. May need to seal it with a sealer and it would be perfect.
on 6/30/2003 2:08:00 PM
Age: 19-24
Skin: Dry, Other, Not Sure
Hair: Blond, Other, Other
Eyes: Blue
I had a hard time drawing a line and the pencil really clumped up on me. The texture initially seemed creamy, but i had to tug at it quite a bit. the price is right and sephora has a huge selection of colors, but unfortunately the pencil just didn't work for me.
on 5/5/2003 11:44:00 AM
Age: 30-35
Skin: Oily, Fair, Not Sure
Hair: Brunette, Other, Other
Eyes: Green
HUGE colour selection! This is a great pencil. Creamy, smooth and smudgable. Wonderful!
on 2/19/2003 5:53:00 PM
Age: Unknown
Skin: Other, Other, Not Sure
Hair: Other, Other, Other
Eyes: Other
Love these! I have it in black and an assortment of colors. They are cheap and the color lasts all day on my lids (which are on the oily side). I prefer the matte to the shimmer for maximum color impact and staying power.
on 1/31/2003 11:42:00 PM
Age: 19-24
Skin: Other, Other, Not Sure
Hair: Other, Other, Other
Eyes: Other
I love these little pencils! For only $4 you can't beat the price. Some of the garbage in the drugstore costs more than that! The glide onto my sensitive eyelids with noo trouble, no tugging or pulling at all. I even find that the small size makes it even easier to apply. These pencils come in great, fun colors as well as everydays blacks, browns, and grays. They wear very well with minimal smudging or 'travelling'. I like these a lot and will continue to buy them again and again.
on 12/16/2002 3:22:00 AM
Age: 25-29
Skin: Very Dry, Other, Not Sure
Hair: Black, Other, Other
Eyes: Black
Not bad... a little pricey for such a small pencil, but the quality is good... nice, and soft pencils, good staying ability.
on 10/10/2002 2:40:00 PM
Age: 18 & Under
Skin: Acne-prone, Other, Not Sure
Hair: Other, Other, Other
Eyes: Other
I have it in Black... they stay on very well with a nice creamy color
Popular Eyeliners
614 Reviews
339 Reviews
2175 Reviews
338 Reviews


text:
Richard GagneJanuary 19,2013
Richard Gagne
NEWPORT Richard Gagne, 55, died Jan. 17, 2013, at North Country Hospital.
He was born Dec. 27, 1957, in Barre, the son of Rosaire and Marion Gagne.
He was a former resident of Brandon Training School.
He was welcomed into the family of Joyce Simons in Barton in 1993, where he lived for more than 17 years. Most recently, he lived with Mary Poulin and her family in Newport.
In addition to them, survivors include his mother, of Barre; a sister, Cheryl Leeton, of Texas; a brother, Stephen Gagne, of New York; and Gerard Boot Boutin, of Barton.
Private burial will be held at a later date in St. Sylvesters Cemetery in Websterville.MORE IN Obituaries
BARRE — Sharon Renault, 61, of Barre, passed away of melanoma Oct. 3, 2015. Full Story
TUNBRIDGE — Jonathan David Wolfe, 45, died Monday, Oct. 5, 2015, at his home in Tunbridge. Full Story
BARRE TOWN — Wendell Dean Fisher, 76, of Barre View Street, Barre Town, passed away in... Full Story
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Wayfair Business JOIN FREE!
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Binder features distinctive embossed surface texture and two-tone cover material with contrasting inside black lining. Slant-D locking rings with GelTab triggers hold up to 25 percent more pages than standard round rings, and are angled for smoother operation and reduced wear. Binder offers label holder, heavy-duty construction, XtraLife Hinge, inside front and back pockets and sheet lifters. Easy-pull finger hole on capacity binders. Product Type: Ring Binder Sheet: Grip Type: Ring Rings: 3 x D Shape - Binder Capacity: Sheet Standard: Letter Recycled: Yes Recycled Content: 45% Post-consumer-waste%: 45% Assembly Required: No Color: Black Brand Name: Cardinal
Weights & Dimensions
|Product Type: Ring Binder
|Country of Manufacture: Mexico
About the ManufacturerCardinal Brands, Inc. was formed November 2000 through a merger between Adams Business Forms, Inc. and Eagle OPG, Inc. Today, Cardinal Brands, Inc. is among the largest office products suppliers in the country, and is recognized as a leader in the design, development and manufacture of high quality, innovative business, consumer and hobby products.
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Globe-Weis Accordion Files with Flap, 21 Pockets, 1/3 Tab, Letha Tone, Letter
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Cardinal Brands, Inc


text:
How the US government can get phone records without asking a judge
Lawyers and former government officials say the subpoena is increasingly used to force people and companies to turn over personal records and other documents
Welcome to the new Independent website. We hope you enjoy it and we value your feedback. Please contact us here.
Lawyers and former government officials say the subpoena is increasingly used to force people and companies to turn over personal records and other documents
During protracted wars in the 1980s and 1990s, the government didn't have a system in place to register births
The Christmas messages of the whistleblower and the monarch dovetail nicely; the one showing off the family addition, the other fearful of a lack of privacy
Whistleblowers say hospices treat non-terminal patients to earn more from Medicare programme
Vehicles and communications gear was seized by the powerful Islamist group
A debatable non-call on Monday night will steal the headlines, but week 11 saw the gap between the haves and have-nots increase further
Not all government functions will simply evaporate — Social Security cheques will still get mailed, and hospitals will stay open. But many federal agencies will send their employees home, from the Environmental Protection Agency to hundreds of national parks. Here's a look at how a shutdown will work.
A partial shutdown of the US government has begun after the two houses of Congress failed to agree a budget last night, with the Republican-led House of Representatives adamant they would only agree to a deal if it included a delay to the start of Obamacare, the President's package of health reforms.
The company made its decision before the shootings at the Navy Yard in Washington DC earlier this week, which left 13 people dead
Internal audit leaked by US fugitive Edward Snowden reveals a litany of infractions, errors and illegal acts since the agency was made more powerful in 2008
The 'Look At Me Now' singer suffered a non-epileptic seizure at a Hollywood recording studio on Friday
Its domestic political coverage and foreign affairs expertise are still excellent
1877: The Washington Post is founded by Democrat representative Stilson Hutchins on December 6 with an initial circulation of 10,000.
What made the whistleblower give up his Hawaiian idyll?
Apple shows a dip in popularity among under-30s
A report on the conflict in Syria by the European Council for Foreign Relations argues two things: one, arming the rebels will only make the situation worse; two, Iran needs to be brought into diplomatic discussions. Donald Macintyre backs the report in today's column for Independent Voices. There is anything but consensus on the issue however, as these pieces from the Financial Times and Washington Post illustrate.
Obama promised to close Guantanamo on his ride to office in 2008. Four years in the White House saw little progress; with blame laid partly at the feet of Congress and partly the President's own slackness. Now he's taking a second run at the notorious Cuban prison-camp, where 100 of the 166 detainees are currently on hunger strike. Here's how the editorial writers at the New York Times and Washington Post responded.


text:
I love this brooch. Romantic open work metal in a dark oxidized gunmetal finish in the design of flowers and leaves and finished off with a bow at the bottom and a dangling faux pearl. When I first saw this I was certain it had marcasites throughout, but I realize it is the cut of the metal which still reflects because of the way in which it is cut.
The brooch measures 1-7/8" wide by 1-3/4" long. Excellent condition.
3 other shoppers have this item in their Cart or Wish List.
Del Mar Classique - Your source for distinctive jewelry, accessories, collectibles and antiques.
Fall Sale! 100's of items - New Additions Daily- Search on keywords FINAL CLEARANCE


text:
Nice to meet you here at this site, where you may use killer ringtones for your mobile. Today we have a ringtone of "Sleeping Sun" by Nightwish as well as 1881 other ringtones by Nightwish. "Sleeping Sun" is a real hit from the "Oceanborn" album that was composed by Nightwish at their major label together with other 32 tracks. You can listen to all 5 Nightwish – "Sleeping Sun" ringtone variations available here and download it for free right now. You can also take a glance at other 24 albums produced by Nightwish for all time. "Sleeping Sun" is referred to Symphonic Metal, and you may listen to a huge amount of Symphonic Metal artists absolutely for free. And finally, we have collected lyrics for this track and you can view it here as well. So feel free to browse, listen, download ringtones at Audiko.net. Make your phone sound cool!
Nightwish Sleeping Sun Ringtone
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text:
Deviant Art
Veritas in Tempus
Chapter One
Unsolicited Dancing
There are occasions and then there are experiences this one crossed over into both. A curly haired Helen Magnus was wearing a gown with a scarlet base, with white pearls sewn around the trim. There was lace covering the bodice which was repeated twice circling around the layers of the skirt that would fit in and be considered part of the high society in the 19th century.
She was guided toward the dance floor by a cohort who swirled her around elegantly in time with the music. The dance floor was beginning to fill with people as more arrived, hiding the delicate engraved flower pattern from the view of the guests on the overhanging balcony.
The only thing that gave this part away for not being in the 19th century was a grey receding haired man on an old style mobile phone; Will Zimmerman. He looked as though he had, had enough of his conversation; his face was getting redder as he got angrier. His pale fac
|Sta.sh Submit


text:
I'm pulling information from the WordPress database. It's definitely pulling all the correct information and if I display the information with
print_r( $res, true ) it shows what i require which is:
[term_id] => 8 [name] => Africa [slug] => africa [COUNT(a.id)] => 1
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text:
Jofran Berkshire Chairside End TableItem # HN-JSI040
- Dimensions: 18W x 22D x 24H inches
- Traditional Louis Phillipe style
- Solid Asian hardwood construction
- Rich cherry veneer
- Brass-finished drawer hardware
Recommended Accessories
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Reviewed by 2 customers
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- Attractive Design
- Good Height
- Good Quality
- Holds Weight Well
Best Uses
- Living Room
Comments about Jofran Berkshire Chairside End Table:
I didn't want matching end tables and purchased this along with the Berkshire chairside table for either end of the sofa. They complement each other nicely. The cherry veneer finish is rich looking and the table's weight is substantial. Assembly was required but quite easy. A local furniture store said it would take six weeks to get them and I had the tables within a week from Coffee Tables Galore. Couldn't be more pleased with the purchase.
- Primary use:
- Personal
- Attractive Design
- Good Height
- Good Quality
- None as of yet
Best Uses
- Living Room
Comments about Jofran Berkshire Chairside End Table:
I have a small living room and wanted something stylish, yet compact. This was perfect.
- Primary use:
- Personal
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text:
View all available promotions
Overall score
would recommend to a friend.
Reviewer score
Would recommend
Pet Friendly......Love It!!!!
Absolutely enjoyed the stay. The staff was outstanding and very helpful when questions arose.
Extremely nice hotel
The people working at the front desk were the nicest employees i've ever delt with at a hotel. The hotel was extremely clean.
Breath taking...
My fiance and I stayed at the Patricia Grand for my 21st birthday/our 2 year anniversary. The room was very neat and clean and the staff was absolutely amazing. Friendly and extremely help. The hotel is right in the middle of everything so we went
to the Ripley's Aquarium, Planet Hollywood, and Medieval Times. It was the perfect getaway. I had stayed at other hotels in the area before but not a single one of them could ever compare to the enjoyment we got out of the Patricia Grand.
Medieval Times is a dinner/medieval tournament. The prices are high but very much worth every penny.
Awesome Vacation and Anniversary
Excellent hotel at the right price. Staff very friendly and sensitive to the customers needs. Everything you could possibly want was offered at the hotel. Great location everything was nearby, shopping, dining, pier, and entertainment. We
enjoyed a relaxing weekend, including the beach, the shopping and dining. I can't wait to return!
The dining in the hotel was excellent and at a reasonable price. We also enjoyed the dining at the seafood restaurants on Kings Hwy., which was a short distance away.
Very nice and relaxing
relaxed. no. I really enjoyed it
The Patricia Grand Resort was the most comfortable resort/hotel i every stayed at. The room was very comfortable and had a lot of room. The room had a beauitful veiw of the ocean and a very nice kitchen. The location was perfect. I'ts just a
wonderful place to stay.
They a have a great restaurant in the hotel. Very good food.
Myrtle Beach Vacation
We stayed in room 320 and the king size bed was WONDERFUL!!! I never slept so good!! We had a corner view of the ocean and beach and it was great we could see and take pictures from our balcony!! We will be going back again!!! We found an Outback
steakhouse on Kings Hwy:D not far from the hotel.
from the hotel go to 28th street up to Kings Hwy and turn right. There are stores of all kinds and if you love Outback there is one on this road!! Remember to buy sunscreen, I forgot and yep I got a burn but there is a Rite aid on Kings Hwy as you turn right on 28th st.
A must for your vacation packages!!!
We like the room, along with the view and the staff. Wonderful hotel, and it was key to making our vacation perfect.
Weekend Getaway
We have stayed at the Patricia Grand Resort before and loved each. It is conveniently located to several shopping centers and shows. We especially enjoy the oceanfront room.
It is conveniently located near the Tanger Outlets, Mall, and dining areas.
Amazing view
my boyfriend and I stayed here and we had a great view of the ocean. We woke up to the sun rise. very very beautiful! We fell asleep with our balcony sliding door open a bit to hear the ocean. the staff was very helpful and polite. Overall, this
place was very nice. The only downfall was that it was not close to the shops we had wanted to go to. Those shops were further down the road. All the shops, food, etc.(along the beach) were 2 miles or so down the road I would definitely recommend this place to anyone! :) However, N Kings Hwy. is a short distance and there are many places to eat and shop along there, just make sure to drive.
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text: POPSUGAR Home Guess Who Guess Who Designed This Bar? by Home 3/12/08 0 Shares Like us on Facebook Sign up for our daily newsletter > Follow us on Pinterest The walls of this bar are covered in large-scale images of Versailles's interiors, table lamps hang upside down from the ceiling as pendants, and mismatched tables and chairs make up the cozy bohemian lounge setting. It was designed by a well-known Frenchman who designs interiors as well as mass-produced consumer goods. Do you know who it is? Read More Bar DecorInterior DesignGuess Who Interior Design Forget Cabo — Meet Mexico's Best-Kept Secret! Breaking Bad Fans, This Coffee Shop Is Your Fix to Postseries Depression 14 Ways to Decorate Like a French Woman The Secret to Scoring Interior Design Services For Cheap POPSUGAR, the #1 independent media and technology company for women. Where more than 75 million women go for original, inspirational content that feeds their passions and interests. Get Inspired With Our Living Newsletter Personalize Vegetarian Love and Sex Food Tech Home DIY Sign up with facebook or By signing up, I agree to the Terms and to receive emails from POPSUGAR.